Magazine article Communication World

The Fen-Phen Summer: Weight Loss Brings Unexpected Results

Magazine article Communication World

The Fen-Phen Summer: Weight Loss Brings Unexpected Results

Article excerpt

Mayo Rochester Cardiologist Michael McGoon had called a few days earlier to let me know that he was going to send me a manuscript with the potential to attract a lot of media attention. It was a series of case reports that concluded there may be an association between taking the weight-loss drugs fenfluramine-phentermine (fen-phen) and developing valvular heart disease. Dr. McGoon's colleague, Dr. Heidi Connolly, was the primary author of the manuscript. It was scheduled to be published in the New England Journal of Medicine in several weeks, so we had some time to plan our communication effort.

While I waded through the 24-page paper, several facts leaped off the page.

* In 1996, physicians wrote more than 18 million prescriptions for a 30-day supply of fen-phen.

* Twenty-four patients with no known heart disease developed valvular problems after taking fen-phen.

* Five of the 24 required surgery to correct the problem.

As I read on, the paper described how a team of physicians, surgeons and allied-health staff from Mayo Clinic and MeritCare Medical Center in Fargo, N.D., had pieced together preliminary evidence linking fen-phen to heart disease:

A 41-year-old woman on fen-phen who underwent valve repair surgery at Mayo Clinic had a very unusual glistening white, thickened heart valve. The same woman later developed a second thickened valve with similar characteristics. Another young woman with previously normal heart function was found to have newly documented valvular problems after taking fen-phen. Twelve patients from North Dakota had the same unusual valve disorder - all had been on fen-phen.

Preparing for a Public Response

Unusual event + many people + significant impact = big news, my PR brain calculated. But my initial equation didn't factor in several events that would take place over the next weeks and months that would make this case series even more significant.

First, a New England Journal of Medicine editor called Dr. Connolly with a rare request that was a strong departure from normal journal policy: Would Mayo be willing to make a statement prior to the publication of the report? Perhaps within the next few days? The journal's editorial board had decided the material in the article had public health implications and needed to be reported early.

After careful consideration, Dr. Connolly and the team of authors - Drs. McGoon, Donald Hensrud, Brooks Edwards, William Edwards, Hartzell Schaff and Jack Crary of MeritCare - agreed. But communicating the study results without a formal scientific publication created a new set of challenges for us.

How could we reach physicians with these findings so they could be prepared for patients' questions? How could we get in touch with the proper people at key governmental agencies such as the U.S. Food and Drug Administration (FDA)? How could we provide accurate information and recommendations to concerned patients who were taking these medicines and would look to us for answers?

We found the answers in another act of Mayo teamwork. Representatives from Video Communications, Mayo's health information web site (, Mayo's institutional web site (, Visual Information, Patient Education, Communications, Administration, Nursing and Cardiovascular Diseases gathered to strategize and implement a plan that included the following:

* Work with the FDA to use their existing procedures and vehicles for communicating with physicians before any formal media announcement. …

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